Home Drugs Methylphenidate

Methylphenidate

Methylphenidate is a potent stimulant prescribed to treat attention-deficit/hyperactivity disorder. Brand names include Concerta, Ritalin and Daytrana. The ADHD drug has a moderate risk of addiction and dependence, calling for extra caution for individuals with a history of substance abuse.

Last Modified: August 14, 2024
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What Is Methylphenidate?

Methylphenidate is a prescription-only drug approved by the U.S. Food and Drug Administration to help control symptoms of ADHD in children and adults. It is also prescribed to treat narcolepsy.

Common methylphenidate brand names include Concerta, Ritalin and Daytrana, but the generic medication is available in certain formulations, including tablets. About 70% of people who take methylphenidate experience better results at school and work because they can focus and ignore distractions brought on by ADHD. A 2015 study showed that a combination drug therapy of methylphenidate and amphetamine improves cognition, memory and self-control for otherwise healthy adults.

People who take methylphenidate can mitigate the additional risk by taking the medication by mouth and only in prescribed dosages. Those who use methylphenidate as a recreational stimulant risk becoming addicted, which carries side effects such as severe psychological and physical dependence, psychosis and tachycardia (fast heart rate).

Is Methylphenidate the Same as Adderall?

Methylphenidate is not the same as Adderall. There are several differences between Adderall and methylphenidate. Adderall is an amphetamine, while methylphenidate is not. Methylphenidate has side effects that are milder than those of Adderall.

Sold through the brand names Adderall IR (for immediate release) and Adderall XR (for extended release), Adderall’s side effects include increased heart rate, decreased appetite and trouble falling asleep. Adderall can cause severe withdrawal symptoms if suddenly stopped.

Individuals taking methylphenidate will notice the effects sooner compared to Adderall. However, it also wears off quicker, whereas Adderall will stay in the body longer. The FDA permits the use of Adderall for children ages 3 to 6. In contrast, methylphenidate is only approved for children ages 6 and older.

What Is Methylphenidate Used to Treat?

Methylphenidate is one of several ADHD medications used to treat the condition in children and adults. Children must be at least 6 years old when diagnosed with ADHD before they can start a methylphenidate prescription.

Physicians also prescribe methylphenidate to treat narcolepsy, a condition of excessive, uncontrollable daytime sleepiness. Results of some studies show a connection between ADHD and narcolepsy. People with narcolepsy are more prone to having ADHD than the general population.

How Does Methylphenidate Work?

Methylphenidate works by increasing the release of dopamine in the brain. Research also suggests that at a less significant amount it may block the reuptake of norepinephrine, resulting in increased norepinephrine.

When taken properly, people with ADHD experience a calming effect to their symptoms of impulsivity and hyperactive behavior.

Methylphenidate has a stimulating effect when taken by someone without ADHD. They may experience increased impulsivity, mood swings and a euphoric high brought on as a dopamine effect. The stimulating effect increases the risk of methylphenidate dependence, abuse and addiction.

Steven Powell, MSN, APRN, NP-C
“Methylphenidate comes in several formulations which can work somewhat differently and provide symptom control for different amounts of time, allowing flexibility and patient specific treatment as needed. ”
Steven Powell, MSN, APRN, NP-C Board-Certified Family Nurse Practitioner

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How Long Does Methylphenidate Stay in Your System?

Once taken, methylphenidate acts for about eight hours, and it may last in your system another four to 64 hours, depending on the formulation – immediate release, extended release and transdermal patch. It may be found in urine screens two to three days (48 to 72 hours) after use. Other tests, such as hair-based analysis, can show that the medication remains in the body up to 30 days after use.

For people with ADHD who take methylphenidate daily, the medication reaches its peak level in the body at four to six weeks. Over time, it metabolizes and gets flushed out by drinking water, a process called de-esterification.

How to Take Methylphenidate

Children and adults take methylphenidate through capsules, chewable and oral tablets, and suspension. Some adults use a skin patch. The chewable form is known as Quillichew.

Methylphenidate is a strong medication that must be prescribed by a physician, who should also monitor its effectiveness and any side effects.

Dosages levels are:
  • Adult Dose: 10-30 mg taken twice or three times a day. The total daily dosage should not exceed 60 mg.
  • Children Ages 13-17: 18 mg once a day with a daily maximum dosage of 72 mg.
  • Children Ages 6-12: 5 mg twice a day before meals with a maximum 60 mg daily dose. Doctors may discontinue treatment if no improvement is made within a month.
  • Children with swallowing problems may take immediate-release methylphenidate, which can be crushed into a powder and mixed with water, juice, milk or yogurt. Crushing extended-release tablets will interfere with their efficiency.
  • Do not take more than the required dosage, even if you miss a dose. Don’t take additional medication to make up for missed doses.

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Methylphenidate Warnings

Methylphenidate carries label warnings about serious cardiovascular events, adverse psychiatric events, long-term suppression of growth, seizures, prolonged and painful erections, visual disturbance and use by children younger than 6.

Let your doctor know if you or your family has a history of Tourette syndrome, facial, motor or verbal tics. You should also inform your doctor if you have an overactive thyroid or experience episodes of anxiety or agitation. Please inform your doctor if you plan on having any surgery, including dental surgery, or have been placed on any form of blood thinners.

Some conditions also may prevent people from taking methylphenidate, including:
  • Agitation marked by anxiety and tension
  • Hypersensitivity to methylphenidate or components of it
  • Glaucoma
  • Tics or family history of tics
  • Hypertension and cardiovascular conditions such as cardiac arrhythmias, heart failure, hyperthyroidism, thyrotoxicosis
  • Abnormal heart rhythm
  • Chronic heart failure or heart attack within the previous 30 days
  • History of drug abuse
  • Cardiomyopathy or arrhythmia
  • Manic behavior and manic depression
  • Abnormal liver function
  • Blockage of the stomach or intestines
  • Priapism
  • Low white blood cells

Most of the warnings about the drug stem from its addictive properties. The drug manufacturer notes that people with a history of substance abuse, primarily of drugs and alcohol, should seriously consider whether they need the medication because of its addictive properties.

Methylphenidate is classified as a federally controlled substance because of the potential for its misuse. The Controlled Substances Act makes it illegal to abuse methylphenidate, which goes by street names skippy, smarties, vitamin R, west coast, pineapple or kiddy cocaine.

Side Effects of Methylphenidate

As a strong medication, methylphenidate has several significant side effects. Among them are irregular heartbeat, chest pain, shortness of breath, seizures, hallucinations and numbness in hands, legs and feet. Contact your doctor immediately or call 911 if you experience any of these effects.

Children are more vulnerable to methylphenidate side effects. Anorexia, tachycardia, hypertension, headaches, insomnia and nausea are the most serious side effects.

Methylphenidate Interactions

Methylphenidate interactions can occur with a handful of other medications: iobenguane 123, isocarboxazid, phenelzine, rasagiline, procarbazine, safinamide and tranylcypromine.

Less severe interactions can happen with other common drugs. These drugs include warfarin, losartan, captopril, timolol and cocaine.

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Please seek the advice of a medical professional before making health care decisions.